The coronavirus (COVID-19) pandemic and the risk of an extensive overload of the healthcare systems have elucidated the need to make decisions on the level of life-sustaining treatment for patients requiring hospitalisation. The purpose of the study was to investigate the proportion and characteristics of COVID-19 patients with limitation of life-sustaining treatment decisions and the degree of patient involvement in the decisions. A retrospective observational descriptive study was conducted in three Danish regional hospitals, looking at all patients ≥ 18 years of age admitted in 2020 with COVID-19 as the primary diagnosis. Lists of hospitalised patients admitted due to COVID-19 were extracted. The data registration included age, gender, comorbidities, including mental state, body mass index, frailty, recent hospital admissions, COVID-19 life-sustaining treatment, ICU admission, decisions on limitations of life-sustaining treatment before and during current hospitalisation, hospital length of stay, and hospital mortality. A total of 476 patients were included. For 7% (33/476), a decision about limitation of life-sustaining treatment had been made prior to hospital admission. At the time of admission, one or more limitations of life-sustaining treatment were registered for 16% (75/476) of patients. During the admission, limitation decisions were made for an additional 11 patients, totaling 18% (86/476). For 40% (34/86), the decisions were either made by or discussed with the patient. The decisions not made by patients were made by physicians. For 36% (31/86), no information was disclosed about patient involvement. Life-sustaining treatment limitation decisions were made for 18% of a COVID-19 patient cohort. Hereof, more than a third of the decisions had been made before hospital admission. Many records lacked information on patient involvement in the decisions.

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维持生命治疗和患者参与决策的局限性：丹麦 COVID-19 患者队列的回顾性研究

冠状病毒 (COVID-19) 大流行和医疗保健系统广泛超负荷的风险表明，有必要就需要住院的患者维持生命的治疗水平做出决定。该研究的目的是调查生命维持治疗决策受限的 COVID-19 患者的比例和特征，以及患者参与决策的程度。在丹麦的三家地区医院进行了一项回顾性观察性描述性研究，研究了 2020 年以 COVID-19 为主要诊断的所有年龄≥18 岁的患者。提取了因 COVID-19 入院的住院患者名单。数据登记包括年龄、性别、合并症，包括精神状态、体重指数、虚弱、最近住院、COVID-19 生命维持治疗、ICU 入院、关于当前住院前和住院期间维持生命治疗限制的决定、住院时间和住院死亡率。共纳入 476 名患者。7% (33/476) 的患者在入院前已做出关于限制维持生命治疗的决定。入院时，16% (75/476) 的患者存在一项或多项维持生命治疗的限制。在入院期间，对另外 11 名患者做出限制决定，总计 18% (86/476)。40% (34/86) 的决定由患者做出或与患者讨论。不是患者做出的决定是由医生做出的。对于 36% (31/86)，没有披露有关患者参与的信息。18% 的 COVID-19 患者队列做出了维持生命的治疗限制决定。其中，超过三分之一的决定是在入院前做出的。许多记录缺乏关于患者参与决策的信息。